Prevalence of bacterial urinary tract infections, antibiogram and associated factors among adults aged 18 to 65 years at Buwenge General Hospital Jinja District, Uganda

Abstract

Urinary tract infection is a medical condition in which the urinary system and the genital tract are colonized by microorganisms that cause disease affecting parts of the system including the urethra, bladder, ureters, nephrons, and vaginal tract. This cross sectional study was carried out at Buwenge general hospital, Jinja district and included 384 participants between the age of 18 and 65 years who were recruited for the study, consent was obtained from them and a questionnaire was filled. A clean catch midstream urine sample was obtained, examined macroscopically, microscopically and then cultured on CLED agar and Blood Agar. Positive plates with significant growth were identified using biochemical tests and gram reactions. A sensitivity testing was then done on the Muller Hinton agar using the Kirby-Bauer disc diffusion technique. Different drugs such were used to determine the sensitivity and antibiogram of each isolated microorganism. Associated factors were analyzed using STATA software. Of the samples collected, 122 had significant growth translating into a prevalence of 31.8% among the study participants. The commonest causative agent of UTI among the study participants was E. coli (39.47%) followed by Citrobacter freundii (28.95%) and Klebsiella pneumoniae (10.53%). The susceptibility pattern of the organisms against the antibacterial agents was varied with P. mirabilis exhibiting complete resistance against all the tested drugs followed by K. pnemoniae. Staphylococcus spp. showed greater sensitivity to the drugs compared to the rest of the isolates. Wiping from front to back during defecation (OR=0.066,CI:O.O1-0.426,P=0.004), being of the male gender(OR=1.837,CI:1.081-3.124,P=0.025), use of antibiotics (OR=0.515,CI:0.269 0.987,P=0.045) an bathing (OR=0.361,CI:0.141-0.92,P=0.033) reduce the risks of acquiring UTI among the studied participants. Antibacterial susceptibility varied greatly with Gram positive organisms showing maximum sensitivity to ampicillin and ampicillin-sulbactam and Proteus mirabilis showing maximum resistance against all the drugs tested. There is need to sensitize the general public on the predisposing factors to UTI, avail diagnostic facilities at most health centers and hospitals, and to carry out more research to establish the link between UTIs and knowledge of the general public on how to avoid them.